Unidad Móvil de Emergencias Valladolid I, Gerencia de Emergencias Sanitarias, Gerencia Regional de Salud de Castilla y León (SACYL), Spain; Centro de Simulación Clínica Avanzada, Departamento de Medicina, Dermatología y Toxicología, Universidad de Valladolid, Spain.
Unidad de Análisis de Datos (UAD) del Instituto de Investigación Sanitaria del Hospital de la Princesa (IIS-IP), Madrid, Spain.
Am J Emerg Med. 2021 Nov;49:331-337. doi: 10.1016/j.ajem.2021.06.042. Epub 2021 Jun 24.
To adapt the Sequential Organ Failure Assessment (SOFA) score to fit the prehospital care needs; to do that, the SOFA was modified by replacing platelets and bilirubin, by lactate, and tested this modified SOFA (mSOFA) score in its prognostic capacity to assess the mortality-risk at 2 days since the first Emergency Medical Service (EMS) contact.
Prospective, multicentric, EMS-delivery, ambulance-based, pragmatic cohort study of adults with acute diseases, referred to two tertiary care hospitals (Spain), between January 1st and December 31st, 2020. The discriminative power of the predictive variable was assessed through a prediction model trained using the derivation cohort and evaluated by the area under the curve (AUC) of the receiver operating characteristic (ROC) on the validation cohort.
A total of 1114 participants comprised two separated cohorts recruited from 15 ambulance stations. The 2-day mortality rate (from any cause) was 5.9% (66 cases). The predictive validity of the mSOFA score was assessed by the calculation of the AUC of ROC in the validation cohort, resulting in an AUC of 0.946 (95% CI, 0.913-0.978, p < .001), with a positive likelihood ratio was 23.3 (95% CI, 0.32-46.2).
Scoring systems are now a reality in prehospital care, and the mSOFA score assesses multiorgan dysfunction in a simple and agile manner either bedside or en route. Patients with acute disease and an mSOFA score greater than 6 points transferred with high priority by EMS represent a high early mortality group.
ISRCTN48326533, Registered Octuber 312,019, Prospectively registered (doi:https://doi.org/10.1186/ISRCTN48326533).
为了适应院前护理的需求，对序贯器官衰竭评估（SOFA）评分进行修改；为此，用乳酸替代血小板和胆红素，对修改后的 SOFA（mSOFA）评分进行测试，以评估从首次接触急救医疗服务（EMS）后 2 天的死亡率风险。
这是一项前瞻性、多中心、基于 EMS 转运的、以救护车上为基础的、针对急性病成年患者的实用队列研究，于 2020 年 1 月 1 日至 12 月 31 日期间在两家三级保健医院（西班牙）进行。使用来自推导队列的预测模型评估预测变量的判别能力，并通过验证队列的接收者操作特征（ROC）曲线下面积（AUC）进行评估。
共有 1114 名参与者来自 15 个救护站，分为两个独立的队列。2 天死亡率（任何原因）为 5.9%（66 例）。通过计算验证队列的 ROC 曲线下 AUC，评估 mSOFA 评分的预测有效性，结果 AUC 为 0.946（95%CI，0.913-0.978，p<0.001），阳性似然比为 23.3（95%CI，0.32-46.2）。
评分系统现在已经成为院前护理的现实，mSOFA 评分可以简单、灵活地评估床边或途中的多器官功能障碍。患有急性疾病且 mSOFA 评分大于 6 分的患者由 EMS 优先转运，代表着一个早期死亡率较高的群体。
ISRCTN48326533，2019 年 10 月 31 日注册，前瞻性注册（doi：https://doi.org/10.1186/ISRCTN48326533）。
